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			<option value="si" name="si" selected="selected">SI</option>
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	  <h2>CRUSADE出血风险评估</h2> 
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	<form name="theform" action="get" id="theform">
		<table cellspacing="0" cellpadding="0" border="0">
		<tbody><tr class="req">
		<td valign="top" class="">基线红细胞压积（%）</td>
		<td class="">
		<ul>
			<li><label>
				<input type="radio" value="9" name="red" id="red"> &lt; 31</label> <small>+9</small>
			</li>
			<li class=""><label>
				<input type="radio" value="7" name="red" id="red"> 31-33.9</label> <small>+7</small>
			</li>
			<li class=""><label>
				<input type="radio" value="3" name="red" id="red"> 34-36.9</label> <small>+3</small>
			</li>
			<li class=""><label>
				<input type="radio" value="2" name="red" id="red"> 37-39.9</label> <small>+2</small>
			</li>
			<li class=""><label>
				<input type="radio" value="0" name="red" id="red"> ≥ 40</label> <small>+0</small>
			</li>
		</ul>
		</td>
		</tr>
		<tr class="req">
		<td class="">肌酐清除率（mL/min）</td>
		<td class="">
		<ul>
			<li><label>
				<input type="radio" value="39" name="ccr" id="ccr"> ≤ 15</label> <small>+39</small>
			</li>
			<li class=""><label>
				<input type="radio" value="35" name="ccr" id="ccr"> &gt;15-30</label> <small>+35</small>
			</li>
			<li class=""><label>
				<input type="radio" value="28" name="ccr" id="ccr"> &gt;30-60</label> <small>+28</small>
			</li>
			<li class=""><label>
				<input type="radio" value="17" name="ccr" id="ccr"> &gt;60-90</label> <small>+17</small>
			</li>
			<li class=""><label>
				<input type="radio" value="7" name="ccr" id="ccr"> &gt;90-120</label> <small>+7</small>
			</li>
			<li class=""><label>
				<input type="radio" value="0" name="ccr" id="ccr"> &gt;120</label> <small>+0</small>
			</li>
		</ul>
		</td>
		</tr>
		<tr class="req">
		<td class="">心率（bpm）</td>
		<td class="">
		<ul>
			<li><label>
				<input type="radio" value="0" name="bpm" id="bpm"> ≤ 70</label> <small>+0</small>
			</li>
			<li class=""><label>
				<input type="radio" value="1" name="bpm" id="bpm"> 71-80</label> <small>+1</small>
			</li>
			<li class=""><label>
				<input type="radio" value="3" name="bpm" id="bpm"> 81-90</label> <small>+3</small>
			</li>
			<li class=""><label>
				<input type="radio" value="6" name="bpm" id="bpm"> 91-100</label> <small>+6</small>
			</li>
			<li class=""><label>
				<input type="radio" value="8" name="bpm" id="bpm"> 101-110</label> <small>+8</small>
			</li>
			<li class=""><label>
				<input type="radio" value="10" name="bpm" id="bpm"> 111-120</label> <small>+10</small>
			</li>
			<li class=""><label>
				<input type="radio" value="11" name="bpm" id="bpm"> ≥120</label> <small>+11</small>
			</li>
		</ul>
		</td>
		</tr>
		<tr class="req">
		<td class="">性别</td>
		<td class="">
		<ul>
			<li><label>
				<input type="radio" value="0" name="gender" id="gender"> 男性</label> <small>+0</small>
			</li>
			<li class=""><label>
				<input type="radio" value="8" name="gender" id="gender"> 女性</label> <small>+8</small>
			</li>
		</ul>
		</td>
		</tr>
		<tr>
		<td class="">有CHF征象</td>
		<td width="35%" class=""><label class="">
		<input type="checkbox" value="7" name="chf" id="chf"> 是</label> <small>+7</small></td>
		</tr>
		<tr>
		<td class="">既往血管性疾病</td>
		<td width="35%" class=""><label class="">
		<input type="checkbox" value="6" name="pvd" id="htn"> 是</label> <small>+6</small></td>
		</tr>
		<tr>
		<td class="">糖尿病</td>
		<td width="35%" class=""><label class="">
		<input type="checkbox" value="6" name="dm" id="dm"> 是</label> <small>+6</small></td>
		</tr>
		<tr class="req">
		<td class="">收缩压（mmHg）</td>
		<td class="">
		<ul>
			<li><label>
				<input type="radio" value="10" name="sp" id="sp"> ≤ 90</label> <small>+10</small>
			</li>
			<li class=""><label>
				<input type="radio" value="8" name="sp" id="sp"> 91-100</label> <small>+8</small>
			</li>
			<li class=""><label>
				<input type="radio" value="5" name="sp" id="sp"> 101-120</label> <small>+5</small>
			</li>
			<li class=""><label>
				<input type="radio" value="1" name="sp" id="sp"> 121-180</label> <small>+1</small>
			</li>
			<li class=""><label>
				<input type="radio" value="3" name="sp" id="sp"> 181-200</label> <small>+3</small>
			</li>
			<li class=""><label>
				<input type="radio" value="5" name="sp" id="sp"> ≥201</label> <small>+5</small>
			</li>
		</ul>
		</td>
		</tr>
		<tr class="answer">
		<td>结果</td>
		<td><input type="text" readonly="readonly" value="点击查看" name="result" id="result"></td>
		</tr>
		<tr class="answer">
		<td colspan="2">
		<div id="resultmsg"></div></td>
		</tr>
		</tbody></table>
	</form>
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